Objective To observe the changes of malondialdehyde (MDA), superoxide dismutase (SOD-1) in serum and plasma endothelin (ET)and angiotensin II(AⅡ) in patients with severe closed head injury before and after being treated with hyperbaric oxygenation (HBO). Methods Fifty patients were recruited. Thirty-two patients were treated with HBO in addition to the conventional management (HBO group) and the other eighteen patients without HBO except for conventional management served as the controls (control group). Thirty healthy volunteers served as normal controls (normal group). Activities of MDA ,SOD-1,ET and AII were measured with spectrometry and radioimmunoassay in all the subjects, respectively, during the study. Results Before treatment, there was a significant difference between the normal group and HBO group as well as the control group in regard to the activities of the 4 parameters(P0.05) as the 4 parameters were concerned. The patients scored 3-5 with GCS in the control group were significantly different from those scored the same with GCS in the normal group in terms of the SOD-1 and MDA. Higher GCS was found in patients with low activities of MDA, ET and AII but high SOD-1 levels. Favourable changes of GCS and GOS were observed in patients in the HBO group as compared with those in the control group (P

Isokinetic training, as a technique of orthopaedic rehabilitation, is a new and valuable method in evaluation of muscle function and in training muscle strength. It has higher accuracy and reproducibility in evaluation of muscle function. When isokinetic training of muscle strength is done, kinetic velocity is fixed beforehand in the dynamic instrument so that the resistance matches the actual force applied by the individual. The resistance maintains the maximum throughout the range of motion and produces the greatest muscle strength. As a result, the isokinetic muscle strength is effective and safe in the orthopaedic rehabilitation.

ObjectiveTo observe the effect of intrathecal injection with Rocephin on intracranial infection after traumatic brain injury.Methods12 patients with intracranial infection after traumatic brain injury were treated with Rocephin, including Rocephin 2.0g vein injection twice a day and 0.1 g intrathecaluse once a day. The germiculture and drug sensitivity test were made before the treatment and antibiotic was selected.ResultsThere were 6 cases recovered, 2 cases improved markedly, 1 case improved and 3 cases unchanged. The efficient rate was 66.7%. The examination of cerebrospinal fluid showed that the levels of leucocyte and protein decreased, the glucose and chloride increased and encephalic pressure declined. 12 bacteria were verified in 12 cases and 8 bacteria were eliminated after treatment. The bacterium cleared rate was 66.7%. There were no side effects correlatives with Rocephin.ConclusionVein and intrathecal injection with Rocephin is effective on intracranial infection after traumatic brain injury.

现代康复医学20世纪80年代初在我国刚刚起步,康复科住院医师培训有待规范化、科学化。本文就康复医学住院医师培训的原则、实施方案进行初步探讨。

Objective To investigate the effect of infrasound on the growth of bone marrow mescenchymal stem cells (BMSCs) and seek the most reasonable duration for using infrasound. Methods The primary BMSCs were obtained from Sprague-Dawley rats through whole bone marrow adherent cultivation.The cells of passage 3 were divided into trial groups treated with infrasound for 10 min,30 min or 60 min,and control groups which were not treated with infrasound but exposed to air for the same durations.The vitality of cell proliferation was measured using the CCK8 method.Apoptosis and the cell cycle were analysed with flow cytometry (FACS). Results After cultivation for 72 h,the optical density (OD) values for BMSCs treated with infrasound for 10 min,30 min and 60 min were 1.480 ± 0.030,1.348 ± 0.030,1.493 ± 0.030 respectively and after 96 h they were 1.774 ± 0.030,1.731 ± 0.030 and 1.833 ± 0.030.All of which were significantly greater than in the control groups ( 1.479 ± 0.030,1.267 ±0.030 and 1.227 ± 0.030 after 72 h and 1.567 ± 0.030,1.563 ± 0.030 and 1.632 ± 0.030 after 96 h).With the extension of the treatment duration,the OD values of the BMSCs increased or increased after decreasing,and the OD value for BMSCs treated with infrasound for 60 min was the highest.The FACS results indicated no effect of infrasound on apoptosis of BMSCs when the treatment duration was 30 min,but that cell apoptosis could be inhibited when the treatment duration was 10 min or 60 min.The early phase apoptosis rates were 1.07％ ± 0.12％ and 0.97％ ±0.21％ in the trial groups treated for 10 min and 60 min respectively,and 1.43％ ± 0.06％ and 3.33％ ± 0.15％ in the respective control groups,a highly significant difference.The results of cell cycle analysis showed infrasound could disturb the cell division of BMSCs significantly when the treatment duration was less than 30 min,but there was no significant effect when the treatment duration was 60 min. Conclusions Infrasound can promote cell proliferation and disturb cell division,but it did not cause apoptosis of BMSCs.When the treatment duration was 60 min,cell proliferation improved steadily,the apoptosis rate decreased,and the cell cycle did not change.So 60 min is the most reasonable treatment duration for infrasound.

Objective To investigate the discriminant validity and relativity of three scales applied in fall risk estimation for senile patients.Methods The timed up and go test (TUGT),the Morse Fall Scale (MFS) and the Berg Balance Scale (BBS) were used by two trained testers to evaluate the fall risk of 161 senile in-patients.The patients were divided into a falling group and a no-fall group based on their history of falling in the previous one year.Student's t-test was applied to compare the discriminant validity of the TUGT,MFS and BBS.Spearman's correlation coefficient was calculated to analyze the correlation among the three scales.Results The scores of patients in the falling group on the three scales were significantly different from those of the no-falls group.The correlation coefficients among the three scales were in the range 0.680-0.888.Conclusion The TUGT,MFS and BBS all showed high sensitivity and good discrimination in fall risks estimation for senile patients.The results with the three scales were highly correlated.Because the emphasis of these three scales is different,a suitable scale should be selected in clinical practice according to the characteristics of the senile patient.

Objective To explore the effect of cilazapril on motor and cognitive function in hypertension with brain stroke. Method 42 hypertensive patients with stroke were divided into cilazapril treatment group(22 cases) and traditi onal treatment group (20 cases). The cilazapril group was treated with Inhibace 2.5 mg～5 mg daily. The traditional group was treated with nifedipine and/or di uretic. The blood pressure was measured twice a day during the treatment course. The activity of daily living (ADL), motor and cognitive function were assessed with Barthel index, Fugl-Meyer and MMSE assessment respectively before and 6 we eks after treatment. Results There were no difference between the two groups on blood pressure effectiveness, but blood pressure was more stable in the cilazapril gro up. Improvement of ADL and lower limb motor function in cilazapril treatment gro up were improved significantly than those of traditional treatment group(P<0.05). Although there was no difference between the two groups in the total value of cognitive function assessment, but the directional ability and memory function in group wa s higher than those in traditional group (P<0.05). Conclusion Cilazapril can decrease blood pressure steadily and can improve the activity of daily living and cognitive function in stroke patients.

Objective: To measure the level of T-lymphocyte subsets and immunoglobulin in severe traumatic brain injury and to explore the clinical significance. Method: 48 cases with severe traumatic brain injury were measured in T-lymphocyte subsets and immunoglobulin of vein blood before and after the rehabilitation therapy. By comparing with the control group and combining clinical evaluation to analyze the immune functional state in the state of TBI and the prognosis. Result:The cellular and humoral immune were inhibited distinctly. The level of CD3 + ,CD4 + ,CD4 +/CD8 +, IgG and IgA of TBI group were lower than the level of the control group. In prognosis, the early immune state of severe disability+vegetable state group was inhibited more seriously than good recovery + mild disability group. Conclusion: The cellular and humoral immune of severe traumatic brain injury were in inhibited state. The severe inhibition of immune, the worse the prognosis.

Objective To analyze the usage of antibiotics after renovation in the use of this present situation and existing problems of pediatrics.Methods By application of our self-developed analyzing system for the clinical use of antibacterial agents,the prescriptions of pediatric outpatient in 2012 was studied retrospectively and their rationality was evaluated.Results The antibiotic prescription rate was 37.7％ in pediatric outpatient and emergency in our hospital,their were 26 antibacterial agents in clinic use which were involved in 6 pharmacological group.The defined daily dose(DDD) analysis was adopted and the results have shown that macrolides (42.20％),cephalosporins (35.90％) and penicillins (20.90％) were the most prescribed antibiotics and most of them were oral medicines (72.2％) and non restrictive drug (61.0％).The antibacterial agents' s combination therapy rate was 2.4％.Irrational use of drugs mainly include the wrong way of administration (78.0％),application of antibiotics with no indications (21.3％) and irrational combined use of antibiotics (0.5％).Conclusion The application of antibiotics in our hospital pediatric basic structure reasonable,but there are still improper usage and dosage,no indication of medicine,etc.It is necessary to further improve and perfect the use and management of antimicrobial agents.